Healthcare Provider Details

I. General information

NPI: 1053490839
Provider Name (Legal Business Name): ANDREW J NEMECHEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 01/27/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E HAMPDEN AVE STE 225
ENGLEWOOD CO
80113-2737
US

IV. Provider business mailing address

2535 S DOWNING ST SUITE 480
DENVER CO
80210-5847
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-9200
  • Fax: 303-781-4368
Mailing address:
  • Phone: 303-778-5658
  • Fax: 303-778-5621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number40976
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: